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Organization
VIVENT PHARMACY LLC
Active
Organization
VIVENT PHARMACY LLC
Active
Other names
Vivent Pharmacy, AMC Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TONY FIELDS PHARMD (CHIEF PHARMACY OFFICER)
(414) 223-6874
Entity
Organization
Contact information
Practice address
1311 N 6TH ST STE 101, MILWAUKEE, WI 53212-4006
(888) 393-0351
(833) 368-1247
Mailing address
1311 N 6TH ST STE 201, MILWAUKEE, WI 53212-4006
(833) 368-1247
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
9049-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100013165
—
WI
01
—
2128078
PK
—
Enumeration date
11/18/2010
Last updated
05/02/2024
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